摘要
目的 :总结小肝癌手术治疗的经验。方法 :回顾性分析本院近 8年 41例小肝癌患者的临床资料 ,其中 3 9例合并肝硬化 ,3 2例HBsAg阳性 ;甲胎蛋白 <2 0 μg·L- 1 13例 ,2 0～ 40 0 μg·L- 1 17例 ,>40 0 μg·L- 1 11例 ;肝功能Child PughA级 2 7例 ,B级 14例。 2 9例予不规则肝切除 (4例病人同时行脾切除加贲门周围血管离断术 ) ,5例予不规则肝切除加无水酒精注射 ,7例予肝左外叶切除 (其中 3例取出门静脉癌栓 )。结果 :术后 1、3、5年生存率依次为 87.8%、73 .2 %、43 .9%。结论 :早发现、早诊断 ,施行合适的外科手术是提高生存率的关键。小肝癌合并门静脉高压症者 。
Objective To summarize experience in surgery for small hepatocellular carcinoma. Methods The clinic data of 41 c as es of small hepatocellular carcinoma in our hospital in recent 8 years were retr ospectively analyzed. Among them,32 cases were HBsAg positive;α-fetoprotein level was less tha n 2 0-μg·L -1 in 13 cases, 20-400-μg·L -1 in 17 and more than 400 -μg·L -1 in 11 cases ; liver function grade Child-Pugh A was found in 27 cases, B in 14. Twenty-n ine cases underwent irregular hepatectomy (including 4 cases received hepatectomy and oper ation for portal hypertension simultaneously), 5 cases underwent irregular and injection of absolute alcohol, 7 cases underwent left lateral lobectomy and 3 c ases underwent removal of the tumor emboli in left portal vein. Result The 1-,3-,5-year survival rates were 87.8%,73.2%,43.9%, respe ct ively. Conclusions Early detection and diagnosis, curative res e ction of tumor are the key points to prolong the survival time of patients.Radic al resection and other operation for portal hypertension during hepatectomy shou ld be cautiously performed on patients with small hepatocellular carcinoma,espe cially combined with portal hypertension at the same time.
出处
《南京铁道医学院学报》
2004年第6期412-414,共3页
Journal of Nanjing Railway Medical College
